The present invention relates to a device and method for treating a fracture in a bone, particularly for treating a wrist fracture. More specifically the present invention relates to devices and methods relating to inserting a first k-wire into bone and then guiding a second k-wire into the bone in parallel or at an angle to the first k-wire within a very narrow space and the invention is well-suited for fractures, fusion, and reduction, for example.
The present invention generally relates to devices used to guide aligning pins, wires, and screws to align bones of the human extremities (upper and lower, for example). More specifically, the present invention relates to devices for axial targeting of scaphoid fractures and the placement of a percutaneous guide wire to correct scapho-lunate instability.
Until recently orthopedic surgeons had inadequate tools to assist in wrist surgeries, particularly related to scapho-lunate instability and non-displaced scaphoid fractures. Prior to that, such repairs to the selected extremity required considerable skill on the part of the surgeon and an even greater amount of guesswork and luck.
When setting fractures, particularly fractures of the hand, the broken or otherwise dislodged bones, typically, are held in a desired alignment with the aid of a Kirshner's wire (K-wire). A common problem with the inserting a K-wire occurs when first inserting the K-wire while also maintaining precise alignment of the arrangement of the bones. This problem also occurs when guiding a drill or placing a cannulated implant. Because of the small diameter of the K-wire (or small diameter of the drill or the size of the cannulated implant, for example) and the limited space between the bones, it was often difficult to determine whether or not the advancing end of the K-wire was aligned, both laterally and vertically, with the carpal bones in the wrist or the elongated metatarsals in the lower extremity. Thus, it is often desired or necessary to place a second K-wire very close to the first K-wire to correct any deficiencies not corrected by the first K-wire. Or, sometimes a second or subsequent K-wire is needed to more precisely align the bones, particularly in the hand, even if the first K-wire was accurately positioned.
One solution to this difficult problem is described by Sommers et al. in U.S. Pat. No. 8,382,758 issued 2013 Feb. 26. Therein, Sommers describes a targeting device that externally clamps to a patient's hand quickly, yet allowing the surgeon to move the patient's hand freely without disrupting the positioning of the targeting guide. Despite the improvement taught by Sommers, there are times when a first guide wire has been placed but the surgeon desires to better align the bones and soft tissue by inserting a second guide wire. Thus, there remains yet a need for another device that enables a surgeon to accurately place a second guide wire based on the position of the first guide wire.
The present invention is directed to overcoming the problems set forth above. It is desirable to have a simple, manually operable device that guides a second wire relative to a first wire that was inserted into an end of a first bone toward an end of a second bone (for example, most indications are axial fixation of one fractured bone, that is scaphoid fractures and Jones Fractures, scapho-lunate instability), while simultaneously aligning the wire so that it is directed in a desired orientation with respect to the first wire. It is also desirable to have a method for pinning two bones together, using the wire insertion guide embodying the present invention, so that the wire is accurately positioned and guided during insertion of the wire through the second bone.